Pharmacy Services- Public Health|MUR|NMS|Clinical Governance

Types of pharmacy service

Dispensing - Supply of medicines and appliances safely. Provision of advice to patients is vital to ensure the effective use of their medicines

Repeat dispensing - This allows the patient to regularly visit their pharmacy for repeat medicines without the need to visit their GP surgery

Disposal of unwanted medicines - Patients can bring their unwanted medicines to the pharmacy for safe disposal

Public Health - Pharmacies are in perfect position to identify patients who may benefit from healthy lifestyle advice. Examples include identifying a smoker who is considering stopping who comes to your pharmacy with a prescription for a ventolin inhaler

Signposting to other healthcare providers - It is important that patients are referred to appropriate care providers or information sources if deemed necessary by the pharmacy team

Self-care - By educating patients about how best to manage their own conditions, whether that be through lifestyle advice or pharmacotherapy recommendations, patients will become empowered and gain maximum benefit from caring for themselves or their families

Clinical governance - ensures that pharmacies are continually striving to proivde excellent care. There are many components of clinical governance that are discussed in more detail here

2. Advanced

Commissioned on a national basis. Includes the following components:

Includes medicines use review (MUR)

New medicine service (NMS)

Appliance Use Review (AUR)

Stoma Appliance customisation service

MURs aim to assess a patients adherence to the prescribed regimen and assess the patients understanding and use of their medicines. The consultation provides an ideal opportunity to identify problems that a patient may be experiencing and can, if deemed necessary, involve referral to their GP. MURs can be conducted on patients taking multiple medicines who have not had an MUR in the previous 12 months (although this interval can be ignored if the pharmacist thinks it is justifiable e.g. if it is apparent that the patient would gain clear benefit from a consultation as they are confused about when and how to take their medicines). At least 70% of MURs should be conducted on patients who fall into one of the target groups. These groups include the following

Patients who have recently been discharged form hospital and had a change to their medicines during their stay

Patients with respiratory disease

Patients at risk of or diagnosed with cardiovascular disease that are regularly taking four or more medicines

NMS aims to improve a patients understanding of their medicine and thereby allow them to get the most out of their medicines. The service has three stages. The first stage is the dispensing stage whereby the medicine is dispensed to a patient and allow appropriate information is provided to the patient to encourage the safe and effective use of that product. The pharmacist and patient will agree a time when the next stage (or the 'intervention') may be carried out. This is usually about two weeks after first dispensing the product. During the 'intervention' stage the pharmacist will aim to assess how the patient is getting on with heir medicine, rectify any problems, and provide further advice about effective medicine use. In some cases if a solution cannot be agreed upon with the patient and effectively implemented the patients GP may need to be involved. If no referral is necessary patients will be contacted after a further 2 weeks to ensure any previously identified issues have been resolved and that the patient is still using their medicine effectively. Only patients with certain conditions are eligible for the NMS. These include those that suffer from the following